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What do you think? This is a difficult case. Only one answer is correct. I suspect only well read people will be able to get this.

PA CXR



































Aneurysm – Usually atherosclerotic rarely mycotic/traumatic
Dissection
Aortic Valve disease – Stenosis or Regurgitation
Cystic medial necrosis- Marfans / Ehlers-Danlos (young patients)
Congenital-Coarctation,PDA                                                        


















Scleroderma/Raynauds
Psoriatic Arthropathy
Hyperparathyroidism
Thermal Injury - Frostbite, Burns, Electrical 
Neuropathic - Diabetes, Syrinx, Leprosy, Asymbolia
Dermatological - Porhyria, Epidermolysis Bullosa
Toxins - Snake, Scorpion bites
Congenital- Infants of epileptic mothers (phenytoin)



Industrial PVC exposure
Hajdu-Cheney disease
Hyperparathyroidism (very unusual presentation)
















 
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